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Posts for category: Dental Procedures

If you've been dealing with a tooth that needs to be removed—or it's already missing—you may be looking to replace it with a dental implant. And it's a great choice: No other restoration can provide the appearance and function of a real tooth like an implant.

You and your smile are ready for it. The question is, though, are your gums and underlying bone ready? These dental structures play a critical role in an implant's stability and eventual appearance. A problem with them may make placing an implant difficult if not impossible.

An implant requires around 2.0 millimeters of bone thickness surrounding the implant surface for adequate support and to minimize the chances of gum recession. But tooth loss often leads to bone loss that can drop its thickness below this threshold. This can make placing an implant problematic.

Fortunately, though, we may be able to address the lack of sufficient bone through bone grafting. By placing grafting material within the empty socket, we create a scaffold for new bone cells to grow upon. Over time this subsequent growth may be enough to maintain an adequate thickness of bone for an implant to be placed.

The gums may also pose a problem if they've shrunk back or receded from their normal positions, as often happens because of gum disease (which may also have precipitated the tooth loss). Again, grafting procedures can help ensure there's adequate gum coverage for the implant. And healthier gums may also help protect the underlying bone from loss.

There are several techniques for placing gum tissue grafts, depending on how much recession has taken place. One procedure in particular is often used in conjunction with implant placement. A small layer of synthetic collagen material or gum tissue referred to as pa dermal apron is included with the implant when its placed. Settling into the bone socket, this apron helps thicken the gum tissues, as well as preserve the underlying bone.

During your preliminary exams, we'll assess your bone and gum health to determine if we should take any steps like these to improve them. It may add some time to the implant process, but the end result will be well worth it.

Over 26 million Americans have diabetes, a systemic condition that interferes with maintaining safe levels of blood sugar in the bloodstream. Over time, diabetes can begin to interfere with other bodily processes, including wound healing—which could affect dental care, and dental implants in particular.

Diabetes affects how the body regulates glucose, a basic sugar derived from food digestion that's the primary source of energy for cell development and function. Our bodies, though, must maintain glucose levels within a certain range — too high or too low could have adverse effects on our health. The body does this with the help of a hormone called insulin that's produced as needed by the pancreas to constantly regulate blood glucose levels.

There are two types of diabetes that interfere with the function of insulin in different ways. With Type I diabetes the pancreas stops producing insulin, forcing the patient to obtain the hormone externally through daily injections or medication. With Type II diabetes, the most common form among diabetics, the body doesn't produce enough insulin or doesn't respond adequately to the insulin that's present.

As mentioned, one of the consequences of diabetes is slow wound healing. This can have a profound effect on the body in general, but it can also potentially cause problems with dental implants. That's because implants once placed need time to integrate with the bone to achieve a strong hold. Slow wound healing caused by diabetes can slow this integration process between implant and bone, which can affect the entire implantation process.

The potential for those kinds of problems is greater if a patient's diabetes isn't under control. Patients who are effectively managing their diabetes with proper diet, exercise and medication have less trouble with wound healing, and so less chance of healing problems with implants.

All in all, though, it appears diabetics as a group have as much success with implants as the general population (above 95 percent). But it can be a smoother process if you're doing everything you can to keep your diabetes under control.

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?”

After a long struggle with dental disease, you have finally lost the last of your remaining teeth.Â Like over a quarter of Americans in their 60s and 70s, this unfortunate development can have a profound impact on your health and self-image.

While there are a number of advanced methods for replacing lost teeth, there's one tried and true option that's centuries old — the removable denture. It's the option millions of people have chosen to lessen the impact of missing teeth.

Fashioned properly, removable dentures restore the form and function you once had with your natural teeth. The prosthetic (false) teeth are precisely placed in an acrylic, gum-colored base that closely follows the contours of your gums. Because they're removable, they're fairly easy to clean and maintain.

They do have a disadvantage, though, and it's related to bone health after tooth loss. Like other living tissues, bone has a life cycle: as older cells die, new cells form to take their place. The forces your teeth generate when you chew stimulate new bone growth. But without teeth to provide this stimulation, new bone won't keep up the pace of replacement at a healthy rate. As a result you may gradually lose bone, as much as a quarter of its normal width within a year of losing a tooth.

Dentures don't transmit any stimulation to the gum and bone from chewing. Furthermore, the compressive forces transmitted to the gum and underlying bone tissue contributes to bone loss. As the bone continues to diminish, your denture fit becomes looser to the point you will eventually need them relined with new acrylic material or have a new set made.

There is another alternative when patients loose all of their teeth: an implant-supported removable denture. Dental implants can be used to keep the dentures more secure and can also slow or even halt bone loss where the implants are placed. In this case we strategically place a few implants to serve as supports for a removable denture. The denture has connection points that join up with the implants to hold it more securely in place. As few as two implants are needed in the lower jaw, while the upper jaw does better with three or four implants.

Losing all your teeth can be traumatic, but there are effective ways to overcome it. With new technology, the traditional restoration of removable dentures may be the vehicle for achieving that.

When you hear the word “dentures” you probably think of an appliance that replaces all the teeth on a dental arch. But there is another type: a removable partial denture (RPD), which can be a viable option for replacing a few missing teeth.

An RPD rests on the bony gum ridges that once held the missing teeth and are secured with clasps or other attachments to adjacent teeth. While lightweight, RPDs are designed to last for many years — they’re made of vitallium, a light but very strong metal alloy that reduces the RPD’s thickness. Recently, metal-free partial dentures are being used that don’t have the fit or longevity of the vitallium partial dentures, but are considered more of a cosmetic solution.

RPDs are custom-made for each individual patient to accommodate the number, location and distribution of teeth missing throughout the mouth. Their design must also reflect the health and stability of the gums and remaining natural teeth to ensure they won’t move unduly during normal mouth function, and will be as lifelike and unnoticeable as possible.

RPDs have been a mainstay in dentistry for many years and represent a less expensive tooth replacement option than implants or fixed bridgework. But they do have their downsides: because of their method of attachment to the remaining natural teeth they tend to accumulate plaque, which increases the risk of both periodontal (gum) disease and tooth decay. Their fit requires that they attach to the adjacent teeth that will cause some damage and lead to their looseness over time.

If you wear an RPD, there are some things you can do to decrease these problems. First and foremost, you should clean your RPD thoroughly every day, as well as brush and floss your remaining teeth to reduce plaque buildup especially at contact points. Be sure to remove the RPD at night while you sleep. And keep up regular dental visits not only for additional plaque removal but also to allow us to inspect the RPD for problems or wear.

An RPD is a viable option for improving mouth function and restoring your smile after multiple tooth loss. With proper care and maintenance, your RPD can serve you well for many years to come.